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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 010213888
Report Date: 06/02/2021
Date Signed: 06/02/2021 11:58:08 AM

Document Has Been Signed on 06/02/2021 11:58 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BRIDGES COMMUNITY CHURCH - LITTLE LAMB MINISTRIESFACILITY NUMBER:
010213888
ADMINISTRATOR:AMY LEEFACILITY TYPE:
850
ADDRESS:505 DRISCOLL ROADTELEPHONE:
(510) 656-1359
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY: 150TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/02/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Amy LeeTIME COMPLETED:
12:00 PM
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Licensing Program Analysts (LPA) Melanie Otsuji and Jonathan Williams met with Director Amy Lee for an announced Case Management inspection, on 6/2/2021, which was initiated by the licensee. This facility was on inactive status effective 9/1/2020 and would like to be placed back on active status.

LPAs toured the facility with the Director. LPAs discussed the importance of keeping hazardous items out of the reach of children. Facility is currently licensed for Rooms 100-110. At this moment due to the COVID-19 pandemic, facility will only be using rooms 100-106. Room 108 will be utilized as an isolation room. Director understands that if Rooms 107, 109 and 110 are to be used, the rooms will need to have any hazardous items removed and/or placed out of reach. The facility has 12 toilets and 10 sinks for use by the children. Facility play yard was inspected and is currently being kept neat and orderly.

Director has current CPR and First Aid certificate which expires 12/14/2021. The facility has a hard wire smoke detector/alarm system monitored by the alarm company, facility has multiple carbon monoxide detectors and charged 2A10BC fire extinguishers. LPAs went over COVID-19 self-assessment check list with the Director.

Facility is approved to be taken off of Inactive Status effective as of today's date, 6/2/2021. No deficiencies cited today. An exit interview was conducted. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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